ST. PAUL, MINN. – The American Civil Liberties Union and the ACLU of Minnesota filed a lawsuit today in Minnesota State Court to challenge the coverage ban on transition-related surgery for transgender people on Medical Assistance and MinnesotaCare, the state’s public insurance programs for low-income residents.

Minnesota’s Medical Assistance program provides coverage for medically necessary care for virtually every type of medical condition. But for gender dysphoria, Minnesota law mandates a sweeping and categorical exclusion of all transition-related surgical care without any regard to whether the treatment is medically necessary for an individual recipient. As a result of this sweeping exclusion, most surgical treatments for gender dysphoria are excluded from coverage even though the same or substantially equivalent treatments are required to be covered under the federal Medicare program and private insurance plans regulated by the State of Minnesota.

“For many transgender people, transition-related surgery is a medical necessity and can sometimes be a matter of life and death. Transgender Minnesotans—like everyone else—should be able to receive adequate health care based on medical standards of care,” said Joshua Block, attorney in the ACLU’s Lesbian, Gay, Bisexual, and Transgender Project. “Every major medical organization has recognized that policies banning coverage for medically necessary transition care have no basis in modern medical science. Minnesota’s statute is a historical relic based purely on disapproval of transgender people.”

The complaint was filed on behalf of plaintiffs Evan Thomas and OutFront Minnesota, the state’s leading LGBTQ rights group, arguing that this ban is discriminatory and has no basis in medical science.

Evan Thomas is currently on Medical Assistance and has been diagnosed with gender dysphoria. After fighting depression all his life, he began hormone therapy and legally changed his name and gender earlier this year. But he has been denied coverage for medically necessary transition-related surgery.

“A weight was lifted when I first began my gender transition and realized I didn’t have to pretend to be a woman anymore,” said Evan Thomas. “Being denied surgical treatment is harmful to my health and well-being every day I’m forced to live in this body.”

OutFront is Minnesota’s largest LGBTQ rights organization and is regularly contacted by transgender individuals on Medical Assistance or MinnesotaCare seeking coverage for transition services, including transition-related surgery. OutFront provides guidance to these individuals regarding Minnesota’s Medical Assistance program and their coverage options.

“Since its inception nearly thirty years ago, OutFront Minnesota has been firmly committed to advancing transgender equality across Minnesota,” said Monica Meyer, executive director of OutFront. “In recent years, we have undertaken a comprehensive approach to eliminating unjust barriers to health care that many transgender people face. Today's lawsuit is a critical part of this effort, and we thank the ACLU and Dorsey & Whitney for their steadfast support for achieving the equal protection of law for Minnesota's transgender community.”

Ten states and the District of Columbia currently cover transition-related surgical care through their public health insurance programs. Transition-related surgery is also covered by Medicare.

The case is filed against the Commissioner of Minnesota’s Department of Human Services, and demands that Minnesota end its discriminatory practice of excluding transgender individuals from accessing all of their needed health care.

Cooperating attorneys in the case include: Kristina Carlson, David Couillard, and JoLynn Markison of Dorsey & Whitney; Teresa Nelson of the ACLU-MN and Joshua Block of ACLU. Read the full lawsuit complaint here.